Rochdale and District Mind

Referral Form

The Open Mind team is the 'gateway' to all the services of Rochdale & District Mind, apart from the Advocacy project, see information here

You can refer yourself, or be referred by a supporting professional, anytime you feel you are experiencing mental distress and would like support.  To access our service, you need to fill in a referral form which is available by: 

(1) Downloading the form  
(2) Completing the online form below
(3) Collecting from our offices on Drake Street  
(4) Telephoning our information line who will post one out to you.

Please note: our services are only available to residents living in Heywood, Middleton or Rochdale.  Rochdale and District Mind adhere to the Safe Haven Fax Principal.  If sending / receiving a fax, please follow the attached guidelines here.

What happens next?

Once we receive your completed form, we will contact you via your preferred method of contact (phone / text / e-mail) to arrange an appointment to see a wellbeing worker.  In this appointment, you will be given the opportunity to tell us your issues, and then we'll draw up an action plan to help meet these needs.


Download Rochdale and District Mind referral form
Complete online referral form


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